Health Navigator I

ABOUT THE ROLE Moda is a company of real people committed to quality, dedicated to building a better future for healthcare. We're proud to be a diverse and inclusive workplace, valuing the unique experiences and perspectives of our employees. As a Customer Service Representative, you'll play a vital role in providing outstanding coverage to our members, compassionate support to our community, and comprehensive benefits to our employees. WHAT YOU'LL DO As a Customer Service Representative, you'll provide phone, email, and chat-based customer service to members of certain Performance Guarantee (PG) and Moda 360 groups. You'll analyze caller's needs and provide timely and accurate responses to a wide variety of issues and questions related to a member's benefits and health program options. This role requires flexibility with your work schedule to meet the client's needs. WHAT YOU'LL NEED To be successful in this role, you'll need: - A high school diploma or equivalent - Ability to complete training as a Customer Service Representative with Moda Health - Claim processing experience, prior customer service experience, or other related experience such as medical/dental office or pharmacy - Practical knowledge of medical, dental, and/or pharmacy terminology - Excellent oral and written communication skills - Ability to interact professionally, patiently, and courteously with customers over the phone and in writing - Excellent analytical, problem-solving, and decision-making skills - 10-key proficiency of 105 kpm net on a computer numeric keypad - Ability to type a minimum of 25 wpm net on a computer keyboard - Ability to work well under pressure in a complex and rapidly changing environment - Ability to maintain excellent attendance and punctuality - Maintain confidentiality and project a professional business presence - Ability to work with multiple applications across multiple monitors at once and learn new applications as needed - Experience using Microsoft Office products, including Outlook, OneNote, and Teams - Experience with TriZetto Facets is helpful - Ability to learn independently and take initiative to constantly improve skills WHY REMOTE This is a full-time work-from-home (WFH) role, offering the flexibility to work from the comfort of your own home. BENEFITS - Medical, dental, vision, pharmacy, life, and disability insurance - 401K matching - Flexible Spending Account (FSA) - Employee Assistance Program - Paid Time Off (PTO) and company-paid holidays